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Pulmonary Embolism Diagnosis — UKMLA MCQ

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HardEmergency MedicinePulmonary Embolism DiagnosisUKMLAMRCEM SBAMRCP Part 1PARA

A patient with a PE Wells score of 5.5 receives immediate CTPA, which shows no pulmonary embolus. He also has new unilateral calf swelling and tenderness. What is the next diagnostic action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Perform proximal leg-vein ultrasound because deep-vein thrombosis is still suspected

Explanation lettering: D = shown as A · A = shown as D

B is correct. After negative definitive chest imaging, NICE advises proximal leg-vein ultrasound when DVT remains suspected. A does not establish an indication for indefinite treatment. C adds repeated radiation and contrast without following the alternative-diagnosis pathway. D-dimer does not confirm PE and is not used to overturn appropriate negative imaging in this sequence. E incorrectly treats a negative pulmonary study as exclusion of leg thrombosis.

Reference: NICE NG158: venous thromboembolic diseases recommendations: https://www.nice.org.uk/guidance/ng158/chapter/Recommendations GMC: PA registration assessment content map: https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/pa-and-aa-prequalification-education-framework/pa-registration-assessment-content-map